程序化镇痛镇静护理在气管插管患者中的应用

The application of protocolized analgesia and sedation in patients with tracheal intubation

目的评价实施程序化镇痛镇静护理降低ICU气管插管非计划性拔管率的效果。方法对2014年1-7月收治的267例经口气管插管患者实施程序化镇痛镇静护理,统计患者谵妄、镇静过度及非计划拔管率,并与2013年1-7月收治的实施经验性镇痛镇静护理的298例患者进行比较。结果 2014年1-7月谵妄发生率为10.1%（27/267）,镇静过度发生率为10.1%（27/267）,非计划性拔管率为1.50%（4/267）,低于2013年1-7月谵妄发生率（26.5%,79/298）、镇静过度发生率（23.2%,69/298）、非计划性拔管率（4.36%,13/298）,差异均有统计学意义（χ2值分别为24.844,16.983和3.959,P〈0.05）。结论运用程序化镇痛镇静护理能够降低ICU谵妄、镇静过度及气管插管非计划性拔管率。

Objective To evaluate the effect of protocolized analgesia and sedation on reducing the incidence of unexpected extubation in the intensive care unit. Methods Protocolized analgesia and sedation was implemented in the experimental group among 267 patients with tracheal intubation admitted to ICU from January to July 2014. The incidence of delirium,excessive sedative and unexpected extubation was compared with the control group in 298 patients admitted to ICU from January to July 2013. Results Significant differences were found in the incidence of delirium（10.1% vs. 26.5%,χ2=24.844,P〈0.01）,excessive sedation（10.1% vs. 23.2%,χ2=16.983,P〈0.01） and unexpected extubation（1.50% vs. 4.36%,χ2=3.959,P〈0.05） between the two groups. Conclusion Protocolized sedation and analgesia can reduce the incidence of delirium,excessive sedation and unexpected extubation in the intensive care unit.